Rheumatoid arthritis (RA) is an autoimmune disease that causes joints all over the body to become inflamed, stiff, painful, and swollen. It can cause damage that can be disabling and permanent. According to the American College of Rheumatology, around 1.3 million Americans have RA.
RA is also a systemic disease. This means it can affect other parts of the body, like organs. As a result, people with RA have a higher risk of heart disease than those who don’t.
Gout is an intensely painful type of arthritis that occurs mainly in the joints of the big toe. It can also attack the top of the foot and ankle. Occasionally, it’s been known to attack other joints in the body.
Gout has been associated with an overabundance of rich food and drink since ancient times. But until the 20th century, only the wealthy could afford such luxuries. The Greek philosopher-physician Hippocrates called gout the “arthritis of the rich.”
At first glance, rheumatoid arthritis (RA) and gout seem almost interchangeable. Both diseases cause redness, swelling, and pain in the joints. Both can cause serious disability and disrupt your quality of life. But there are some tendencies that differentiate the diseases:
- Gout usually occurs in the foot, most commonly at the base of the big toe.
- RA can affect any joint on either side of the body, but most commonly occurs in the small joints of the hands, wrists, and feet.
- Gout is always accompanied by redness, swelling, and intense pain.
- A joint affected by RA also may become painful, but won’t always be red or swollen.
- RA pain varies in quality and intensity. Sometimes it’s mild, and sometimes it’s excruciating.
The best way to know whether you have RA or gout is to make an appointment with your doctor for a diagnosis.
The medical community doesn’t yet know what causes RA. However, scientists think the disease has a genetic component, and is then triggered by something in the environment, like a virus.
Rich food and drink can cause gout indirectly. But the real culprit is purines. These chemical compounds are found in certain foods. Purine-rich foods include most meats (especially organ meats), most fish and shellfish, and even some vegetables. Wholegrain breads and cereals contain purines too.
The body converts purines into uric acid. Gout can occur whenever there is too much uric acid in the blood. Uric acid is normally excreted in the urine, but high levels can form sharp crystals in the joints, causing inflammation and intense pain.
RA can be treated, but not cured. Once RA has been diagnosed, your rheumatologist will choose treatments according to the severity of your disease.
Active, severe RA usually is treated with powerful biologic disease-modifying antirheumatic drugs (DMARDs). They work to slow or stop the progression of the disease, and can relieve inflammation and pain.
Mild-to-moderate RA is treated with non-biologic DMARDs. These drugs are still quite effective. Nonsteroidal anti-inflammatory drugs (NSAIDs) are also used to treat RA, often in addition to DMARDs.
Gout traditionally has been treated by limiting intake of rich foods and alcohol. But other treatments are far more effective.
Drugs that treat gout include:
- NSAIDs, such as indomethacin or naproxen
- corticosteroids, such as prednisone
- colchicine, which may be given with NSAIDs to prevent future attacks
- medications that block the production of uric acid crystals
These diseases may look and feel the same, but they have different causes and tendencies. Because of these differences, people who have RA can also have gout — and vice versa.
Excess weight stresses the joints of the hips, knees, ankles, and feet, and can make RA worse. It’s always smart to keep your body weight under control by eating a balanced, healthy diet and limiting your alcohol consumption — and your chances of acquiring gout.